Provider Demographics
NPI:1558722454
Name:SCHAEFFER, KATHRYN ANNE (RD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S 51ST ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-6967
Mailing Address - Country:US
Mailing Address - Phone:515-695-3780
Mailing Address - Fax:515-225-6197
Practice Address - Street 1:555 S 51ST ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-6967
Practice Address - Country:US
Practice Address - Phone:515-695-3780
Practice Address - Fax:515-225-6197
Is Sole Proprietor?:No
Enumeration Date:2016-03-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079903133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered